Irish Journal of Medical Science

, Volume 179, Issue 1, pp 51–55 | Cite as

An audit of hip fracture services in the Mater Hospital Dublin 2001 compared with 2006

  • L. Cogan
  • A. J. Martin
  • L. A. Kelly
  • J. Duggan
  • D. Hynes
  • D. Power
Original Article



Evidence-based practice supports the provision of integrated geriatric multidisciplinary care for older people with hip fractures.


To show that introduction of orthogeriatric services resulted in improved care and better patient outcomes.


We compared two audits: a 2001 audit of 103 patients over the age of 65 years with hip fracture and a 2006 audit on 98 admissions using the same parameters.


Inpatient mortality dropped from 20% to 8%. Discharge to home increased from 8% to 18% and to nursing home fell from 25% to 21%. Prescription of perioperative antibiotics, DVT prophylaxis and osteoporosis medications improved. There were no significant differences in age or sex but there were significantly higher levels of disability in the 2001 group.


Following introduction of an orthogeriatric service, improvements in mortality and discharge destination occurred. This may have been influenced by higher proportions of disability among the 2001 cohort.


Hip fractures Aged Orthogeriatrics Osteoporosis Geriatrics 



We would like to acknowledge the input of Ms. M. Vartuli from the Information Management Services in the Mater Misericordiae University Hospital for providing length of stay data.


  1. 1.
    Marottoli RA, Berkman LF, Cooney LM (1992) Decline in physical function following hip fracture. J Am Geriatr Soc 40:861–866PubMedGoogle Scholar
  2. 2.
    Zuckerman JD (1996) Hip fracture. N Engl J Med 334(23):1519–1525. doi: 10.1056/NEJM199606063342307 CrossRefPubMedGoogle Scholar
  3. 3.
    Cameron ID, Handoll HH, Finnegan TP, Madhok R, Langhorne P (2001) Co-ordinated multidisciplinary approaches for inpatient rehabilitation of older patients with proximal femoral fractures. Cochrane Database Syst Rev (3):CD000106Google Scholar
  4. 4.
    Cameron I, Crotty M, Currie C, Finnegan T, Gillespie L, Gillespie W (2000) Geriatric rehabilitation following fractures in older people: a systematic review. Health Technol Assess 4(2):i–iv 1–111PubMedGoogle Scholar
  5. 5.
    Halbert J, Crotty M, Whitehead C, Cameron I, Kurrie S, Graham S, Finnegan T, Foleys A, Shanahan M (2007) Multi-disciplinary rehabilitation after hip fracture is associated with improved outcome: a systematic review. J Rehabil Med 39(7):507–512. doi: 10.2340/16501977-0102 CrossRefPubMedGoogle Scholar
  6. 6.
    British Orthopaedic Association (2007) The care of patients with fragility fractures. British Orthopaedic Association, United KingdomGoogle Scholar
  7. 7.
    Hommel A, Ulander K, Thorngren K-G (2003) Improvements in pain relief, handling time and pressure ulcers through internal audits of hip fracture patients. Scand J Caring Sci 17(1):78–83. doi: 10.1046/j.1471-6712.2003.00212.x CrossRefPubMedGoogle Scholar
  8. 8.
    The Scottish Hip Fracture Audit Report 2008. ISD Scotland Publications, NHS National Services Scotland, Edinburgh.
  9. 9.
    Prevention and Management of Hip Fracture in Older People Scottish Intercollegiate Guidelines Network (SIGN), Royal College of Physicians, Edinburgh, 2002.
  10. 10.
    Mater Misericordiae University Hospital Corporate Plan 2004–2006; Dublin, Ireland, 2004.
  11. 11.
    Keating JF, Grant A, Masson M, Scott NW, Forbes JF (2006) Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty: treatment of displaced intracapsular hip fractures in healthy older patients. J Bone Joint Surg Am 88(2):249–260. doi: 10.2106/JBJS.E.00215 CrossRefPubMedGoogle Scholar
  12. 12.
    Gillespie WJ, Murray D, Gregg PJ, Warwick D (2000) Risks and benefits of prophylaxis against venous thromboembolism in orthopaedic surgery. J Bone Joint Surg Br 82(4):475–479CrossRefPubMedGoogle Scholar
  13. 13.
    Gillespie WJ, Walenkamp G (2001) Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures. Cochrane Database Syst Rev (1):CD000244Google Scholar
  14. 14.
    Strategy to Prevent Falls and Fractures in Ireland’s Ageing Population Health Service Executive, Ireland, 2008.
  15. 15.
    Parker MJ, Currie CT, Mountain JA, Thorngren KG (1998) Standardised audit of hip fracture in Europe (SAHFE). Hip Int 8:10–15Google Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2009

Authors and Affiliations

  • L. Cogan
    • 1
    • 2
  • A. J. Martin
    • 1
  • L. A. Kelly
    • 1
    • 2
  • J. Duggan
    • 1
  • D. Hynes
    • 3
  • D. Power
    • 1
  1. 1.Department of Medicine for the Older PersonMater Misericordiae University HospitalDublin 7Ireland
  2. 2.Keele UniversityStaffordshireUK
  3. 3.Department of Orthopaedic SurgeryMater Misericordiae University HospitalDublin 7Ireland

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